Characteristic | MD | RN |
|---|---|---|
Age | 47 (40, 55) | 43 (35, 51) |
Unknown | 42 | 64 |
Years Since Training | 16 (8, 24) | 13 (8, 22) |
Unknown | 53 | 79 |
Gender | ||
Female | 210 (27%) | 593 (78%) |
Male | 547 (71%) | 152 (20%) |
Nonbinary | 1 (0.1%) | 3 (0.4%) |
Gender not listed/prefer to self describe (Please specify): | 1 (0.1%) | 1 (0.1%) |
Prefer not to answer | 12 (1.6%) | 9 (1.2%) |
Unknown | 37 | 64 |
Race | ||
White | 581 (77%) | 640 (85%) |
Black or African American | 20 (2.7%) | 28 (3.7%) |
Asian | 80 (11%) | 28 (3.7%) |
American Indian or Alaska Native | 0 (0%) | 5 (0.7%) |
Native Hawaiian or Other Pacific Islander | 1 (0.1%) | 1 (0.1%) |
Multiple races | 17 (2.3%) | 15 (2.0%) |
Prefer not to answer | 53 (7.0%) | 32 (4.3%) |
Unknown | 56 | 73 |
Hispanic | ||
No, not Hispanic or Latino | 721 (94%) | 705 (93%) |
Yes, Hispanic or Latino | 49 (6.4%) | 52 (6.9%) |
Unknown | 38 | 65 |
RUCA Regions | ||
Urban | 743 (93%) | 679 (83%) |
Suburban | 43 (5.4%) | 75 (9.1%) |
Rural | 17 (2.1%) | 66 (8.0%) |
Unknown | 5 | 2 |
Magnet Status | ||
Yes | 279 (36%) | 276 (36%) |
No | 109 (14%) | 413 (55%) |
I don't know | 381 (50%) | 68 (9.0%) |
Unknown | 39 | 65 |
1Median (Q1, Q3); n (%) | ||
Principal Component Analysis of Clinician Information Sources During the Early COVID-19 Pandemic
We relied on four dimensions, corresponding to: (1) professional networks (e.g., ED leadership, hospital leadership), (2) news and social media (e.g., Facebook, Twitter/X), (3) academic publications (e.g., peer-reviewed journals, society communications), and (4) blogs and podcasts. Only factor loadings greater than 0.5 are noted, representing strong associations between information sources and their respective components.
Number and percentage of clinicians who adopted each innovation, shown overall and by provider type (nurses vs. physicians). Results are presented for all clinicians and for the subset with decision-making discretion for each innovation.
| Innovation Adoption by Provider Type | ||||
| Number and percentage of adopters | ||||
| Innovation | Sample |
Clinician Type
|
Total | |
|---|---|---|---|---|
| Physicians | Nurses | |||
| PPE reuse | All clinicians | 729 (93.1%) | 731 (93.4%) | 1460 (93.2%) |
| PPE reuse | Flexible for this innovation | 305 (89.2%) | 153 (85.5%) | 458 (87.9%) |
| High-flow oxygen | All clinicians | 690 (88.2%) | 555 (71.2%) | 1245 (79.7%) |
| High-flow oxygen | Flexible for this innovation | 658 (90.8%) | 431 (81.6%) | 1089 (86.9%) |
| Ivermectin | All clinicians | 37 (4.7%) | 67 (8.6%) | 104 (6.7%) |
| Ivermectin | Flexible for this innovation | 30 (5.0%) | 29 (15.9%) | 59 (7.5%) |
Clinician ratings of information use and perceived reliability across source categories during early COVID-19 (Mar–Jun 2020). Bars show means by clinician type (MD vs. RN) with 95% CIs; percentages indicate the share who used at least one source per category. Asterisks denote significant differences between physicians (MDs) and nurses (RNs) after Holm correction for multiple comparisons (*** p < 0.001, ** p < 0.01, * p < 0.05).
Venn diagram showing the number and percentage of clinicians with discretion in decision-making who reported implementing PPE reuse, high-flow oxygen (HFO), and ivermectin (IV) during the early COVID-19 pandemic. Overlapping regions indicate clinicians who implemented more than one innovation. Counts and percentages are displayed within each region. Bold labels identify the three innovation categories.
| Adjusted Odds Ratios (all) | |||||
| Predictor | OR | 95% CI (Lower) | 95% CI (Upper) | P-value | OR (Label) |
|---|---|---|---|---|---|
| Professional Networks | 0.956 | 0.530 | 1.709 | 0.880 | 0.96 |
| News and Social Media | 2.001 | 1.235 | 3.394 | 0.007 | 2.00** |
| Academic Publications | 1.516 | 0.833 | 2.807 | 0.178 | 1.52 |
| Blogs and Podcasts | 0.571 | 0.330 | 0.976 | 0.042 | 0.57* |
| Age | 0.981 | 0.953 | 1.010 | 0.193 | 0.98 |
| Female (vs. Male) | 1.388 | 0.645 | 3.092 | 0.411 | 1.39 |
| Other or Unknown Gender (vs. Male) | 0.444 | 0.044 | 10.250 | 0.523 | 0.44 |
| Suburban (vs. Urban) | 0.387 | 0.152 | 1.095 | 0.057 | 0.39+ |
| Exurban/Rural (vs. Urban) | 1.233 | 0.519 | 3.303 | 0.654 | 1.23 |
| Perceived Flexibility | 0.068 | 0.023 | 0.194 | 0.000 | 0.07*** |
| Physician (vs. Nurse) | 1.732 | 0.685 | 4.301 | 0.238 | 1.73 |
| Physician x Flexibility | 4.376 | 1.208 | 16.429 | 0.026 | 4.38* |
| Adjusted Odds Ratios (all) | |||||
| Predictor | OR | 95% CI (Lower) | 95% CI (Upper) | P-value | OR (Label) |
|---|---|---|---|---|---|
| Professional Networks | 0.865 | 0.628 | 1.188 | 0.373 | 0.87 |
| News and Social Media | 1.112 | 0.860 | 1.452 | 0.425 | 1.11 |
| Academic Publications | 1.360 | 0.962 | 1.930 | 0.083 | 1.36+ |
| Blogs and Podcasts | 1.192 | 0.876 | 1.625 | 0.264 | 1.19 |
| Age | 0.997 | 0.981 | 1.014 | 0.753 | 1.00 |
| Female (vs. Male) | 1.001 | 0.661 | 1.513 | 0.997 | 1.00 |
| Other or Unknown Gender (vs. Male) | 1.146 | 0.364 | 5.097 | 0.835 | 1.15 |
| Suburban (vs. Urban) | 1.319 | 0.726 | 2.577 | 0.388 | 1.32 |
| Exurban/Rural (vs. Urban) | 1.090 | 0.667 | 1.851 | 0.740 | 1.09 |
| Perceived Flexibility | 1.222 | 0.741 | 2.065 | 0.443 | 1.22 |
| Physician (vs. Nurse) | 1.585 | 0.965 | 2.631 | 0.071 | 1.58+ |
| Physician x Flexibility | 1.582 | 0.763 | 3.252 | 0.214 | 1.58 |
| Adjusted Odds Ratios (all) | |||||
| Predictor | OR | 95% CI (Lower) | 95% CI (Upper) | P-value | OR (Label) |
|---|---|---|---|---|---|
| Professional Networks | 0.551 | 0.316 | 0.959 | 0.035 | 0.55* |
| News and Social Media | 1.501 | 1.028 | 2.170 | 0.032 | 1.50* |
| Academic Publications | 1.623 | 0.896 | 2.975 | 0.113 | 1.62 |
| Blogs and Podcasts | 0.893 | 0.533 | 1.491 | 0.666 | 0.89 |
| Age | 1.018 | 0.990 | 1.047 | 0.208 | 1.02 |
| Female (vs. Male) | 1.384 | 0.688 | 2.778 | 0.360 | 1.38 |
| Other or Unknown Gender (vs. Male) | 1.575 | 0.080 | 9.852 | 0.684 | 1.57 |
| Suburban (vs. Urban) | 1.563 | 0.594 | 3.628 | 0.327 | 1.56 |
| Exurban/Rural (vs. Urban) | 1.319 | 0.582 | 2.786 | 0.485 | 1.32 |
| Perceived Flexibility | 0.339 | 0.129 | 0.816 | 0.020 | 0.34* |
| Physician (vs. Nurse) | 0.307 | 0.124 | 0.738 | 0.009 | 0.31** |
| Physician x Flexibility | 1.391 | 0.426 | 4.767 | 0.590 | 1.39 |
Forest plot showing adjusted odds ratios (aORs) and 95% confidence intervals for predictors of clinicians’ decisions to suggest or implement three COVID-19–related practices: PPE reuse, high-flow oxygen, and ivermectin. “Perceived Flexibility” reflects increased flexibility among nurses. “Physician (vs. Nurse) reflects the impact of being a physician rather than nurse among clinicians with some flexibility. “Physician × Flexibility” indicates whether the association between perceived flexibility and adoption differed for physicians compared with nurses. For PPE reuse, an aOR of 4.38 (>1) shows that while greater flexibility reduced reuse for both groups, the drop was steeper for nurses than for physicians. Significance: *** p < 0.001, ** p < 0.01, * p < 0.05, † p < 0.10.
Bar chart illustrating the percentage of clinicians with decision-making flexibility who cited each factor as influencing their decision to implement the innovation, grouped by adopters versus non-adopters. Significant differences indicate that adopters were more likely to cite the justification than non-adopters, with the exception that “Evidence from medical literature” was more commonly cited by those who did not suggest or prescribe ivermectin (76%) compared with those who did (59%) Asterisks indicate statistically significant differences between groups after multiple comparison correction (*** p < 0.001, ** p < 0.01, * p < 0.05).